Chp: 41 Diabetes Insipidus (DI) & (SIADH) Questions

B. Increased hematocrit

A nurse is Assessing a client who has a diabetes insipidus. The nurse should expect which of the following findings? A. Decreased heart rate B. Increased hematocrit C. High urine specific gravity D. Low BUN level

A. Sodium 110 mEq/L

A nurse is assessing a client who has syndrome of inappropriate antidiuretic hormone SIADH. Which of the following findings should the nurse report to the provider? A. Sodium 110 mEq/L B. 2+ deep-tendon reflexes C. Potassium 3.7 mEq/L D. Urine specific gravity 1.025

A. Increased urine osmolarity D. Weight gain E. Distended neck veins

A nurse is assessing for a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following findings should the nurse expect? (Select all that apply.) A. Increased urine osmolarity B. Bradycardia C. Polyuria D. Weight gain E. Distended neck veins

A. Excessive urinary output C. Hypernatremia E. Tachycardia

A nurse is comparing the pathophysiology of diabetes insipidus (DI) with the pathophysiology of syndrome of inappropriate antidiuretic hormone (SIADH). Which manifestations below show DI? (Select all that apply.) A. Excessive urinary output B. Fluid retention C. Hypernatremia D. Hyponatremia E. Tachycardia F. Weight gain

B. Fluid retention D. Hyponatremia F. Weight gain

A nurse is comparing the pathophysiology of diabetes insipidus (DI) with the pathophysiology of syndrome of inappropriate antidiuretic hormone (SIADH). Which manifestations below show SIADH? (Select all that apply.) A. Excessive urinary output B. Fluid retention C. Hypernatremia D. Hyponatremia E. Tachycardia F. Weight gain

D. "Report nocturia because it requires a dosage adjustment."

A nurse is preparing a teaching plan for a client who has diabetes insipidus and requires intranasal desmopressin. Which of the following information should the nurse include? A. "Drink at least 3 liters of fluid per day." B. "Weigh yourself weekly while wearing similar clothing at the same time of day." C. "Notify the provider of a weight loss of 1 pound or more per week." D. "Report nocturia because it requires a dosage adjustment."

B. "Blow your nose gently prior to using the nasal spray."

A nurse is providing discharge teaching to a client who has diabetes insipidus in a new prescription for desmopressin nasal spray. Which of the following instructions should the nurse include in the teaching? A. "Depress the pump once before using the nasal spray for the first time." B. "Blow your nose gently prior to using the nasal spray." C. "Administer the nasal spray while in a side-lying-position." "Notify the provider if you develop numbness or tingling around the mouth."

A. "You should notify the provider if you experience diarrhea."

A nurse is providing information to a client who has a new prescription for demeclocycline to treat syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following statements should the nurse make? A. "You should notify the provider if you experience diarrhea." B. "You should take this medication with an antacid if you develop GI distress." C. "You should avoid using sunscreen while taking this medication." D. "You should change positions carefully while taking this medication."

A. Low sodium C. Increased urine osmolality D. High urine sodium E. Increased urine specific gravity

A nurse is reviewing the laboratory findings for a client who has SIADH. Which of the following findings should the nurse anticipate? (Select all that apply.) A. Low sodium B. High potassium C. Increased urine osmolality D. High urine sodium E. Increased urine specific gravity

B. Decreased specific gravity

A nurse is reviewing the laboratory findings for a client who has diabetes insipidus. Which of the following urinalysis findings should the nurse expect? A. Presence of glucose B. Decreased specific gravity C. Presence of ketones D. Presence of red blood cells

A. Serum and urine electrolytes C. Osmolality D. Urine-specific gravity

A patient is suspected of having diabetes insipidus and is admitted to the medical-surgical nursing unit. Which diagnostic test does the nurse anticipate the provider will order? (Select all that apply.) A. Serum and urine electrolytes B. CT scan C. Osmolality D. Urine-specific gravity E. Lumbar puncture

C. Decreased urine output Rationale: SIADH is characterized by increased secretion of ADH leading to water reabsorption, decreased urine output, and dilutional hyponatremia. Polyphagia, polyuria, and glucosuria are common clinical manifestations of diabetes mellitus.

The nurse correlates which findings to a diagnosis of SIADH? A. Polyuria B. Polyphagia C. Decreased urine output D. Glucosuria

C. Seizures Rationale: As serum sodium levels decrease in patients with SIADH, the patient may have seizures or become comatose, particularly with serum sodium levels fall below 120 mEq/L. The neurological signs associated with the hyponatremia are related to osmotic fluid shifts in the brain that lead to cerebral edema and increased intracranial pressure.

The nurse monitors the patient with SIADH for which complication secondary to a serum sodium level of 120 mEq/L? A. Hypotension B. Hyperglycemia C. Seizures D. Bradycardia

B. Decreased Rationale: ADH secretion is decreased as a result of damage to the posterior pituitary gland. This decrease causes the body to excrete more water.

This or That? For each option, select the correct answer relative to central diabetes insipidus (DI). Antidiuretic Hormone (ADH) Production A. Increased B. Decreased

B. Hypotension Rationale: With polyuria and dehydration, blood pressure will decrease.

This or That? For each option, select the correct answer relative to central diabetes insipidus (DI). Blood Pressure A. Hypertension B. Hypotension

A. Tachycardia Rationale: Dehydration will cause the heart rate to increase.

This or That? For each option, select the correct answer relative to central diabetes insipidus (DI). Heart Rate A. Tachycardia B. Bradycardia

B. Hemoconcentration Rationale: DI causes a rise in hematocrit levels resulting in hemoconcentration of the blood due to fluid loss.

This or That? For each option, select the correct answer relative to central diabetes insipidus (DI). Hematocrit A. Hemodilution B. Hemoconcentration

A. Increased Rationale: In DI, one would expect to see an increase in serum osmolality from the loss of water in the urine. Increased

This or That? For each option, select the correct answer relative to central diabetes insipidus (DI). Serum Osmolality A. Increased B. Decreased

A. Hypernatremia Rationale: As the blood loses water, it becomes more concentrated and the serum sodium level rises.

This or That? For each option, select the correct answer relative to central diabetes insipidus (DI). Serum Sodium A. Hypernatremia B. Hyponatremia

A. Increased Rationale: DI results in intravascular dehydration, which activates the thirst mechanism

This or That? For each option, select the correct answer relative to central diabetes insipidus (DI). Thirst & Urine Output A. Increased B. Decreased

B. <200 MOsm/Kg Rationale: Decreased urine osmolality of less than 200 mOsm/kg is a key indicator of DI. This is a result of the water eliminated in the urine.

This or That? For each option, select the correct answer relative to central diabetes insipidus (DI). Urine Osmolality A. >200 MOsm/Kg B. <200 MOsm/Kg

A. 1.000 Rationale: Urine-specific gravity is less than 1.005 in patients who have DI. The urine is dilute from the loss of water.

This or That? For each option, select the correct answer relative to central diabetes insipidus (DI). Urine-Specific Gravity A. 1.000 B. 1.030

D. Urine osmolality 190 mOsm/kg

Which assessment finding is most likely to occur in a patient with diabetes insipidus (DI)? A. Hypertension B. Urine specific gravity 1.005 C. Serum sodium 140 mg/dL D. Urine osmolality 190 mOsm/kg